Kornimate/medical-research-clean huggingface dataset:
tracking t-cell responses to evaluate pembrolizumab effectiveness in advanced non-small cell lung cancer

Conditions: NSCLC (Advanced Non-small Cell Lung Cancer); NSCLC Stage IV Without EGFR/ALK Mutation; NSCLC Adenocarcinoma

Summary: this study includes patients with advanced non-small cell lung cancer (nsclc) - either unresectable stage iii or stage iv adenocarcinoma without actionable driver mutations - who are treated with pembrolizumab in combination with platinum-based doublet chemotherapy, irrespective of pd-l1 expression levels. the primary objective is to assess treatment response through integration of serial t-cell receptor (tcr) repertoire sequencing (rep-seq), capturing longitudinal changes in t-cell clonality and diversity. these immune dynamics will be correlated with radiographic response assessed by recist 1.1, with the aim of improving the accuracy of response classification, including differentiation between progression, pseudo-progression, and hyperprogression. additionally, circulating tumor dna (ctdna) levels will be measured longitudinally (pre-treatment and during treatment) to evaluate their potential as a complementary biomarker of disease burden and treatment efficacy in the context of chemo-immunotherapy.


Eligibility criteria:
inclusion criteria: * histologically confirmed diagnosis of nsclc adenocarcinoma stage iv or unresectable stage iii. * have measurable disease based on recist 1.1. * eastern cooperative oncology group (ecog) performance status of 0 to 1. * adequate organ function. exclusion criteria: * aberration in one or more of molecular drivers. * has received prior systemic anti-cancer therapy prior to allocation. * known active cns metastases and/or carcinomatous meningitis. * known additional malignancy.

Keywords: metastatic nsclc adenocarcinoma first-line pembrolizumab
methylene blue vs cyanokit for intraoperative vasoplegic syndrome in liver transplant patients

Conditions: Vasoplegic Syndrome; Liver Transplant; Complications

Summary: this study will evaluate if hydroxocobalamin may be a new and possibly superior treatment for refractory vasoplegic syndrome during liver transplant surgery.


Eligibility criteria:
* patients scheduled to undergo liver transplantation * patients able to read and understand consent document (if patient is unable to provide an informed consent, the legally authorized representative will be ask to consent on behalf of the patient). * svr lower than 500 dynes-sec/cm-5 intraoperatively (this criterion must be met after consent intraoperatively)

Keywords: hydroxocobalamin methylene blue
study of flat polyp detection using new narrow band imaging (nbi) compared to white light colonoscopy - the find flat colonoscopy study

Conditions: Colorectal Neoplasms; Colonic Polyps; Colorectal Cancer

Summary: we hypothesize that high definition narrow band imaging (nbi) colonoscopy compared to high definition white light colonoscopy will detect an increased number of nonpolypoid (flat and depressed) colorectal neoplasm.

interval colorectal cancers diagnosed within a three year period following a clearing colonoscopy have been reported at a rate of 1 cancer/1000 person years.the majority of these cancers are likely a consequence of a missed neoplastic lesion during routine colonoscopy. recent tandem colonoscopy studies have shown no significant difference in adenoma miss or detection rates using narrow band imaging as compared to colonoscopy using white light. however, higher detection of flat neoplastic lesions using nbi was shown in a meta-analysis and should be furthered studied, especially considering that they are thought to be a strong contributor to a false negative colonoscopy.

Eligibility criteria:
inclusion criteria: * adult patients referred for routine colonoscopy are eligible exclusion criteria: * known inflammatory bowel disease * referred for endoscopic evaluation and removal of colorectal lesion * personal or family history of polyposis or non-polyposis syndrome * presentation for emergency endoscopy * inability to remove polyp due to coagulopathy or thrombocytopenia * inability to provide informed consent

Keywords: colonoscopy diagnostic imaging colorectal neoplasm tandem colonoscopy flat polyp nonpolypoid flat and depressed lesions primary prevention endoscopy
identification of mechanism in the erythroid response in patients with myelodysplasia undergoing chelation therapy

Conditions: Myelodysplasia; Myelofibrosis; Aplastic Anemia

Summary: the study aims to evaluate the molecular mechanism underlying the erythroid response observed in some patients with myelodysplasia, myelofibrosis and aplastic anemia treated with deferasirox or deferoxamina.


Eligibility criteria:
inclusion criteria: 1. patients aged 18 and older 2. diagnosis of myelodysplasia, myelofibrosis or aplastic anemia 3. transfusion-dependent anemia undergoing chelation therapy with deferasirox or deferoxamine exclusion criteria: * none

Keywords: mds pmf cmml aa
restricted calorie ketogenic diet as a treatment in malignant tumors

Conditions: Malignant Tumors

Summary: malignant tumor incidence showed an upgrade trend in recent years. standard therapy for malignant tumor includes surgery followed by radiation and chemotherapy. despite optimal treatment the prognosis remains poor. there is an urgent need for more effective therapies. the warburg effect has been widely observed in human cancers. the main energy supply of tumor cells are aerobic glycolysis. therefore, they are highly dependent on glucose metabolism. recently, some scholars have suggested that 'restricted calorie ketogenic diet (rkd)' might be able to inhibit glycolysis and thus anti-tumor by restricting carbohydrate intake. this will 'starve' cancer cells, which will lead to cell death. there are many animal and in vitro studies shown that rkd can reduce the tumor size and thus tumor cell growth of malignant tumors. however, a consistent positive result can not be found within a small sample of clinical trials. in this study, 40 patients with malignant tumors will be treated with or without rkd. the safety and efficacy of rkd and the patients' tolerance will be observed in order to understand whether this therapy can be a potential new treatment this clinical study is comparatively large internationally. it is the first domestically. this study is essential to extend the survival of patients with malignant tumors, and to study clinical nutrition support and its metabolic pathways for malignant tumors.


Eligibility criteria:
inclusion criteria: 1. 40 patients with diagnosed/recurrent malignant tumors 2. ability and willingness to sign informed consent form. exclusion criteria: 1. anticoagulation treatment with coumadin≥ 1 mg/day for ≤ 7 days prior to screening (low-dose \[≤ 1 mg/day\] coumadin, heparin, and low-molecular-weight heparin are permitted) 2. any systemic illness or unstable medical condition that might pose additional risk, including: cardiac, unstable metabolic or endocrine disturbances, renal or liver disease, past history of renal calculi, hyperuricemia, hypercalcemia, mitochondrial disease, known disorder of fatty acid metabolism, porphyria, carnitine deficiency and pancreatitis 3. history of malignant tumors other than malignant glioma, such as surgical resection of non-melanoma skin cancer or cervical carcinoma in situ. 4. history of uncontrollable hyperlipidemia. 5. active drug or alcohol dependence or any other factors that, in the opinion of the site investigators, would interfere with adherence to study requirements 6. history of having human immunodeficiency virus, or hepatitis c 7. failure to recover from \<ctcae grade 2 toxicities related to prior therapy 8. pregnancy or breastfeeding. 9. use of any investigational drug within 1 months of enrollment 10. inability or unwillingness of subject to give written informed consent
two daily disposable contact lenses in symptomatic patients

Conditions: Myopia

Summary: the purpose of this study is to evaluate the performance of dailies total1® and acuvue oasys® 1-day and with respect to visual acuity in a symptomatic study population of monthly or bi-weekly replacement lens wearers.


Eligibility criteria:
inclusion criteria: * able to understand and must sign an irb-approved informed consent form; * soft contact lens wearers in both eyes during the past 3 months; * best-corrected visual acuity (bcva) 20/25 or better in each eye; * willing to wear study lenses at least 3 days per week and at least 8 hours per day; * willing to stop wearing habitual contact lenses for the duration of study participation. exclusion criteria: * infection, inflammation, abnormality, condition, disease, surgery, or use of medications, as specified in the protocol; * intolerance, hypersensitivity, or allergy to any component of the study products; * wearing habitual contact lenses in an extended wear modality (routinely sleeping in lenses for at least 1 night per week) over the last 3 months prior to enrollment; * monocular (only one eye with functional vision).

Keywords: symptomatic
use of a smartphone application to predict the prognosis in patients with newly diagnosed multiple sclerosis.

Conditions: Multiple Sclerosis

Summary: multiple sclerosis (ms) is a chronic demyelinating disease of the central nervous system for which the investigators now have many treatment alternatives. these treatments have a preventive goal and the data in the literature suggest the interest in rapidly achieving optimal control of the disease in order to decrease the risk of long-term disability progression. one of the current unmet needs is to have markers that can be used at the individual level to predict the long-term prognosis in order to propose optimal and personalized therapeutic management. classically used clinical markers do not meet this need. it is recognized that there is a so-called silent course of ms (not measurable by clinical parameters), which may, after several months or years, be expressed as a physical or cognitive disability. mri is the reference examination for monitoring the sub-clinical activity of the disease but it does not allow the neurodegenerative side of the disease to be assessed. other blood or imaging markers are being studied but are not yet usable in daily practice. the project aims to evaluate the interest in using digital biomarkers, based on a rapid assessment of patients using a locally developed mobile application (ms screen test - msst) to predict the evolutionary prognosis of the disease.


Eligibility criteria:
inclusion criteria: * patient between 18 and 60 years of age * presenting a diagnosis of relapsing-remitting ms defined according to mcdonald 2017 criteria confirmed within 6 months prior to inclusion * starting first-line treatment (interferon beta, glatiramer acetate, teriflunomide, dimethyl fumarate) * having an encephalic and cervical mri in ofsep format, within 6 months prior to inclusion * no relapse within 30 days prior to inclusion exclusion criteria: * presence of a motor, visual or cognitive deficit not related to ms
efffectiveness of a roller intervention in anterior knee pain

Conditions: Anterior Knee Pain Syndrome

Summary: anterior knee pain is one of the most frequent reasons for consultation within knee conditions in adolescents and young adults. however, despite the high prevalence of this disorder, its pathogenesis and therefore its treatment are not clearly understood. foam rolling has become a common intervention to enhance joint mobility and muscle recovery after exercise. the aim of this study is analyze the effectiveness of a roller intervention in patients with anterior knee pain.

randomized controlled trial. patients were divided into two groups, intervention and control.

Eligibility criteria:
inclusion criteria: * patients between 18 and 65 years. * knee anterior pain diagnosis exclusion criteria: * concomitant somatic or psychiatric disorder * previous knee surgery * other lower limb traumatological pathologies

Keywords: roller intervention knee pain algometry
improvement of tolerance of bowel cleansing before colonoscopy in diabetic patients

Conditions: Diabetes Mellitus; Colonic Diseases

Summary: this trial will compare the tolerance to 2 different methods for colon cleansing before colonoscopy in diabetic patients.

consecutive diabetic patients undergoing an ambulatory colonoscopy at the participating sites will be randomized to 2 different methods of colon cleansing before the procedure. both will be based on the oral ingestion of a fluid solution (half of it on the evening before the procedure is planned and the rest on the morning of the same day), and the main difference between them will be the volume of fluid that will be ingested in each case. analogic visual scales and standardized questionnaires on various aspects that may influence the degree of satisfaction about the preparation will be answered by the participants and collected before the colonoscopy. the endoscopist, blinded to the preparation method, will grade the adequacy of the preparation. adverse events will be recorded up to 1 month after the procedure

Eligibility criteria:
inclusion criteria: * patients scheduled for a diagnostic, screening or follow-up outpatient colonoscopy * diabetes mellitus (being treated with insulin or any oral agent). exclusion criteria: * unwillingness to participate. * hospital admission at the time of colonoscopy. * inability to follow instructions * active inflammatory bowel disease * previous colectomy. * incomplete colonoscopies due to technical reasons or contraindication for the procedure as evaluated by the endoscopist

Keywords: colonoscopy diabetes mellitus polyethylene glycols ascorbate personal satisfaction
brain markers of treatment response in post-traumatic stress disorder (ptsd)

Conditions: Post-traumatic Stress Disorder

Summary: the purpose of this study is to examine if treatment of post-traumatic stress disorder in combat veterans with paroxetine changes brain responses as measured by functional magnetic resonance imaging and if brain responses can predict who will get better with treatment.


Eligibility criteria:
inclusion criteria: * veterans with clinical diagnosis of post-traumatic stress disorder from combat related to deployment to afghanistan/iraq (operation enduring freedom/operation iraqi freedom) exclusion criteria: * intolerance or sensitivity to paroxetine * major medical or neurologic illness * current psychotropic medication or active psychotherapy treatment * other major psychiatric illness
accelerated ctbs on metabolic dysfunction in people with schizophrenia

Conditions: Schizophrenia; Metabolic Disturbance; Eating Behavior; Transcranial Magnetic Stimulation

Summary: ctbs is a promising novel intervention, which has strong potential on moderating disease syndrome. however, the most effective pattern of the ctbs is still under debate. therefore, the investigators designed this randomized controlled clinical trial to evaluate the efficacy and safety of accelerated ctbs, with 1800 stimulation per session, on intervention to metabolic side effects in individuals with schizophrenia.


Eligibility criteria:
inclusion criteria: * patients diagnosed with schizophrenia in accordance with dsm-5 * bmi over 24 * accepting antipsychotics stable treatment for more then 2 months exclusion criteria: * diagnosed with other mental disease in accordance with dsm-5 * comorbid with other severe physiological disease * used antipsychotic, antidepressants, mood stabilizer, or other psychoactive substances before * drug or alcohol abuse * pregnant or lactating contraindication to rtms

Keywords: schizophrenia metabolic disturbance ctbs event related potentials
adequate duration of antibiotic treatment in community-acquired pneumonia with high risk class and adequate initial clinical response

Conditions: Community-acquired Pneumonia

Summary: non-inferiority, multicenter, prospective double-blind, randomized clinical trial of two parallel groups. the randomization between the 2 study groups will be carried out according to a scheme generated by a computer program, in blocks of 6 and stratified by centers. the antibiotic treatment will be evaluated during 5 days compared to the usual antibiotic treatment for more than 7 days in patients with community-acquired pneumonia with a pneumonia severity index iv-v severity score who present an adequate response in the first 4 days of hospital antibiotic treatment.


Eligibility criteria:
inclusion criteria: * patients of both sexes older than 18 years * hospitalized patients diagnosed with cap: appearance of a new radiological infiltrate plus the presence of at least two of the following signs or symptoms: fever (\> 38 ° c), cough, expectoration, chest pain, dyspnea or tachypnea, and signs of occupation of the alveolar space. * that they present a psi score class iv or v. * patients who have received adequate antibiotic treatment according to clinical guidelines (separ, ats) ((1,8,19)) from the first hour of admission to the emergency room. * patients who reach clinical stability: temperature ≤37.2 ºc, heart rate ≤100 beats / min, respiratory rate ≤24 breaths / min, systolic blood pressure\> 90 mmhg; oxygen saturation\> 90%; or oxygen blood pressure\> 60 mmhg (15) before the fourth day. * signature of informed consent. exclusion criteria: * immunosuppression: co infection with hiv and presence of aids, treatment with neutropenic effect or have received immunosuppressive treatment for any reason. patients that are in chronic use of corticosteroids as prednisone or its equivalent with \> 10 mg / day for 14 days. * patients hospitalized in the previous 14 days. * patients with pleural effusion * suspected multiresistant germs of any cause. * hypersensitivity or alterations in the tendons associated with the fuoroquinolones. * pregnancy or lactation.
eltrombopag and high-dose dexamethasone as first line treatment for it

Conditions: Immune Thrombocytopenic Purpura

Summary: the purpose of this study is to determine the response rate and response duration with the combination of eltrombopag and high-dose dexamethasone

immune thrombocytopenia is an autoimmune disorder characterized by formation of autoantibodies against platelet antigens leading platelet destruction. corticosteroids increase the platelet count in about 80 percent of patients.however, many patients have a relapse when the dose of corticosteroid is reduced. debilitating side effects are common in patients who require long-term corticosteroid therapy to maintain the platelet count. eltrombopag, it is a small molecule agonist of the c-mpl (tpor) receptor, which is the physiological target of the hormone thrombopoietin, has been shown to be effectively raise the platelet count in adult patients (aged 18 years and over) who have had their spleen removed or where splenectomy is not an option and have received prior treatment with corticosteroids or immunoglobulins, and these medicines did not work (refractary itp). there are a few case reports where eltrombopag was an option as first line treatment for it. the purpose of this study is to determine the response rate and response duration with the combination of eltrombopag (50mg po once a day for 4 weeks) and high-dose dexamethasone (40mg po days 1,2,3,4) in untreated adult patients immune thrombocytopenic or in patients with less than 7 days of treatment with corticosteroids. a complete platelet response is defined as an increase in platelet counts to \>150×109/l on two consecutive occasions. a partial response is defined as an increase in the platelet count to between 50 and 150×109/l on two consecutive occasions, 1 week apart. duration of response is considered from the day of the initial administration to the first time of relapse (platelet count \<30×109/l)or to time of analysis. at the end of the first 5 weeks, the patients will followed by 6 months every month.

Eligibility criteria:
inclusion criteria: * clinically confirmed immune thrombocytopenic (it) platelet count less than 30,000/mm3 on two occasions. platelets \>30000/mm3 with bleeding. * less than seven days taking corticosteroids * normal to increased numbers of megakaryocytes on bone marrow examination in patients ≥ 60 years * subject is ≥ 18 years * subject has signed and dated written informed consent. * no sepsis or fever * no active infection requiring therapy * no active chronic viral infection * hiv negative * not pregnant or nursing * negative pregnancy test * fertile patients must use effective contraception exclusion criteria: * performance status above or equal to 2. * previous treatment with eltrombopag * immunosuppressive treatment within the last month * previous splenectomy * presence of malignant haematological disease * connective tissue disease * autoimmune hemolytic anemia * pregnancy and lactation * not willing to participate in the study.

Keywords: eltrombopag dexamethasone high-dose itp
diclofenac premedication, as the effect of preemptive analgesia after post-thoracotomy chest and shoulder pain

Conditions: Pain; Inadequate or Impaired Respiratory Function

Summary: the purpose of the study is to examine if the hyposthesis of the preventive analgestic characteristic of diclofenac given preoperatively has any effect on postoperative thoracic wall and shoulder pain sensation. we also want to examine the rescue analgetic consumption and the postoperative lung function test values.

introduction thoracotomies are thought to be one of the most difficult surgical incisions to deal with post-operatively, because they are extremely painful and the pain can prevent the patient from breathing effectively. currently in our institute the surgical and post-operative anelgesia are managed by the combination of local anesthetics and opioid pain killers through an epidural cannula. in addition the investigators give diclofenac intravenously (from the 2nd day after the operation per os) as well as nalbuphin is given intravenously to the patients if it is necesserary. by definition pre-emptive analgesia means that the treatment of pain is initiated before the surgical procedure by analgetics or nerve blockade techniques. the purpose of this method is to inhibit the production of inflammatory mediators and the prevention of the pain stimulus entering the central nervous system. as a result of the pre-emptive antinociceptive treatment, the quantity of post-operative medications can be decreased, the analgesia has less complications and the patients are more satisfied. in the study the researchers would like to examine the pre-emptive analgetic effect of diclofenac. patients and methods: patients undergoing thoracotomy are divided into two groups.: * study group: 100mg diclofenac per os (n=50) * control group: patients do not get diclofenac premedication (n=50) the investigators examine every patient for five days: they record the patients' pain with the help of the visual analogue scale (vas). we measure the analgetic consumption in intramuscular morphin equivalent dose and the local anesthetic consumption via epidural cannula seperately. the lung function testing was carried out two times postoperatively with the help of the mir spirolab ii mobil spirometer.

Eligibility criteria:
inclusion criteria: * 100 thoracotomy patients who agreed to take part in our study and signed a consent * age 18-80 years * asa i-iii * men/women equally * thoracotomies are managed with using intratracheal double lumen tube * insertion of thoracic epidural cannula and during the operation administration of 1mg/ml bucain, 5microgr/ml fentanyl solution, with 0.1ml/kg body mass/hour speed exclusion criteria: * acute operation * diclofenac allergy in the anamnesis * the lack of thoracic epidural cannula

Keywords: thoracotomy pain management analgesia postoperative care premedication preventive